HARM REDUCTION

What is Harm Reduction?

This section is copied from Human Rights Watch’s article: ”We Know What to Do, Harm Reduction and Human Rights in North Carolina,” with permission by Human Rights Watch. Harm reduction is a way of preventing disease and promoting health that “meets people where they are” rather than making judgments about where they should be in terms of their personal health and lifestyle. Accepting that not everyone is ready or able to stop risky or illegal behavior, harm reduction focuses on promoting scientifically proven ways of mitigating health risks associated with drug use and other high risk behaviors, including condom distribution, access to sterile syringes, medications for opioid dependence such as methadone and buprenorphine, and overdose prevention.

Emphasizing public health and human rights, harm reduction programs provide essential health information and services while respecting individual dignity and autonomy. For drug users, harm reduction recognizes that many drug users are either unable or unwilling to stop, do not need treatment, or are not ready for treatment at a given time. Harm reduction programs focus on limiting the risks and harms associated with unsafe drug use, which is linked to serious adverse health consequences, including HIV transmission, viral hepatitis, and death from overdose.

Harm reduction programs have been shown to lower HIV risk and hepatitis transmission, prevent overdose, and provide a gateway to drug treat- ment programs for drug users by offering information and assistance in a non-judgmental manner. Harm reduction also protects law enforcement officers from needlestick injuries—accidental pricks to the skin from handling hypodermic needles. By providing safe disposal of injection equipment, harm reduction programs reduce the number of contaminated syringes circulating in a community.

Important principles of harm reduction programs include:

A non-judgmental approach that treats every person with dignity, compassion, and respect, regardless of circumstance or condition.

Utilizing evidence-based, feasible, and cost-effective practices to prevent and reduce harm;Accepting behavior change as an incremental process in which individuals engage in self-discovery and transition through “stages of change;”

Active and meaningful participation of drug users, former drug users, and community stakeholders in shaping sensible policies and practices around drug use;

Focusing on enhancing quality of life for individuals and communities, rather than promoting cessation of all drug use;

Recognizing complex social factors that influence vulnerability to drug use and drug-related harm, including poverty, social inequality, discrimination, and trauma;

Empowering drug users to be the primary agents in reducing the harms of their drug use;

Commitment to defending universal human rights.

Harm reduction encompasses a broad range of activities and interventions designed to improve the health and quality of life of individuals and communities. These include:

Provision of primary care and treatment for HIV and other sexually transmitted or blood-borne infections;

Referrals to drug treatment programs.

Testimonials

“The help I got from the harm reduction program was more than just clean equipment, it was about being with people who didn’t judge me for my addiction, and who really wanted to help.” Sam, a 50-year-old former drug user and sex worker in Carrboro, NC

“Too often, drug users suffer discrimination, are forced to accept treatment, marginalized, and often harmed by approaches which over-emphasize criminalization and punishment while under-emphasizing harm reduction and respect for human rights. This is despite the longstanding evidence that a harm reduction approach is the most effective way of protecting rights, limiting personal suffering, and reducing the incidence of HIV.” —Navanethem Pillay, UN High Commissioner for Human Rights, March 10, 2009

In the National HIV/AIDS Strategy for the US, access to sterile syringes is endorsed as one of several “scientifically proven...approaches that reduce the probability of HIV transmission.” The federal ban on funding for syringe exchange programs was lifted in 2009 in the US, yet local laws prevent many states from expanding syringe access. State and local laws that restrict access to harm reduction services undermine both public health and human rights.